Procalcitonin in early detection of postoperative complications

A prospective clinical study was performed to assess the accuracy of procalcitonin in 70 patients with elective colorectal or aortal surgery and to compare it with inflammatory mediators. Also the early prediction of complications and the outcome of these patients was taken into account.

Laboratory variables and cytokine determination were obtained preoperatively, on the day of operation and postoperatively on a daily basis from day 1 to 5, and on days 7 and 10 in the colorectal group and in the aortal surgery group at different times on the operation day after aortal clamping. The main outcome criteria were early recognition of complications and alterations in the production of procalcitonin and cytokines in order to detect severe infective complications.

Procalcitonin was closely related to postoperative complications with significantly elevated levels at day 1 after surgery. The plasma concentrations of IL-6 increase on days 1-3 without a difference in the groups, also C-reactive protein demonstrates no differences.

Procalcitonin presents itself as a new parameter of infection and sepsis. In the postoperative period PCT seems to be an interesting marker of early prediction of infective complications when high postoperative levels are found. Under routine conditions procalcitonin is a valid reproducible and detectable parameter.